异体血清治疗重度干眼的临床研究  

The clinical research of allogeneic serum for the treatment of severe dry eye

作　　者：陈元[1] 辜凤娟 刘权[1] 张琪[1] 赵敏[1] 

机构地区：[1]重庆医科大学附属第一医院眼科,400016

出　　处：《中国实用眼科杂志》2016年第2期134-138,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察异体血清滴眼液治疗重度干眼的疗效，探讨其有效性、安全性、适应证及应用前景。方法自身配对研究。对2013年1月至2014年7月在重庆医科大学附属第一医院眼科收治的重度干眼46例（89只眼），其中女性35例（67只眼），男性11例（22只眼），因各种原因未能使用自体血清而采用异体亲属血清替代治疗。采用自身配对设计，观察并记录异体血清滴眼液治疗2周（50％浓度）及1个月（20％浓度）前后畏光、异物感、干涩感、眼红、视力、BUT、荧光素染色、Sit试验等改善情况。结果治疗2周后，所有患者畏光、异物感、干涩感减轻，差异有统计学意义（t=9．18、7．65、5．94，P〈0．01）；客观体征如眼红、荧光素染色亦有改善，差异有统计学意义（t=5．62、8．00，P〈O．01）；视力、BUT、Sit等指标虽有改善，但差异无统计学意义（t=1．50、1．75、1．37，P〉0．05）。治疗1个月后，上述主客观表现除Sit值仍无明显提高，差异无统计学意义（t=1．74，P〉0．05）外，余指标均较前明显改善，差异有统计学意义（t=14．04、21．29、20．73、20．65、8．91、20．50、10．29，P〈0．05）。异体血清治疗期间，无1例出现不良反应，所有患者舒适度均满意，安全性良好。结论异体血清治疗重度干眼疗效确切，未发现明确不良反应，安全有效。对于一些无法或不适宜使用自体血清的特殊干眼患者，异体血清滴眼液成为了有效的替代手段。Objective To observe the therapeutic effect of allogeneic serum ,eye drops on severe dry eye, further to investigate its effectiveness, security, indication and application prospect. Meth- ods Forty-six severe dry eye patients （67 eyes of 35 female patients, 22 eyes of 11 male patients）, which were unsuited for autologous serum were included in the study, who were treated with allogeneic serum eye drops instead of autologous serum eye drops. Self-paired design was used on pre and post-treatment （2 weeks with 50% concentration and 1 month with 20% concentration）, the scores of photophobia, dry and unsmooth sensation, foreign body sensation, redness,visual acuity, corneal fuorescent staining, tear breakup time （tBUT）, the Schirmer test without anesthesia （Schirmer I test） were recorded. Results On two weeks post-treatment, reduction in the scores of photophobia, dry and unsmooth sensation, foreign body sensation were observed in all patients （t =9.18, 7.65, 5.94, P 〈0.01）; accordingly, obviously improvements in the degrees of redness, corneal fluorescent staining were detected （t =5.62, 8.00, P 〈0.01）. No significant differences in visual acuity, tBUT, Schirmer I test were observed （t =1.50, 1.75, 1.37, P 〉0.05）. After one month of treatment, in addition to the above objective and subjective symptoms Sit still had no significant improvement （t = 1.74, P 〉0.05）, the remainder were significantly improved than before, and the difference was statistically significant （t =14.04, 21.29, 20.73, 20.65, 8.91, 20.50, 10.29, P 〈0.05）. No side effects were observed during study. Conclusions Allogeneic serum is an effective way to treat the unique patients with severe dry eye in clinical, because of its safety and effectiveness. For these patients, allogeneic serum turned to be an effective alternative.

关 键 词：异体血清 重度干眼 临床研究 

分 类 号：R512.805[医药卫生—内科学]